Associação entre a concentração sérica de TSH e o carcinoma papilífero de tireoide.

Abstract

Increasing evidences points to serum TSH (Thyroid Stimulating Hormone) as an independent predictor for diagnosis of thyroid carcinoma in patients with nodular thyroid disease, but the mechanisms underlying this finding remain unexplained. Currently is not clear if the TSH is involved in the development of thyroid cancer, progression or both. This study aims to contribute for elucidation this issue. The main objective is evaluate the correlation of TSH levels with the emergence of papillary thyroid carcinoma, and if it is possible to estimate whether the use of this parameter as a predictor of the emergence of this type of cancer. A retrospective analysis was performed on patients’ pre-existing database from private histopathology clinic, in Campina Grande - PB, in period from 2010 to 2012, who underwent diagnostic investigation of thyroid nodules by fine needle aspiration (FNA) and/or biopsy and who had serum TSH value before these procedures. We included patients with TSH levels between 0.5 to 5.0 mg/dl, values which are not yet well established correlation with papillary thyroid carcinoma, and exclude those with non-diagnostic sample in the analysis of FNA. After analysis of 636 nodules, there was not found a relationship between higher levels of TSH with occurrence of nodular malignant disease in the total sample. However, this relationship was significant when analyzed only females (p=0.03). The male sample did not show the same results, possibly because it does not constitute a numerically significant sample, this fact may have influenced the total study sample. Furthermore, we found a relationship between lower levels of TSH and benign findings (Class II Bethesda) on FNA. Unable to establish a cutoff point from which we have a greater risk malignancy in patients with nodular disease, but the relationship still can not be denied. Future studies could address this point specifically.